Methods for Item Management

ABSTRACT

Item-management systems, apparatus, and methods are described, preferably for management of items such as medicaments. In a method embodiment, a method of hand-loading a container with at least one type of medicament is provided. A portable container having plural cells for holding medicament-type items is gotten and is docked at a docking station. Visible information, preferably viewable on the docked container, indicates the cell into which each medicament is to be hand-loaded. The visible information assists a user to hand-load a medicament into the correct cell. The docked container is removed from the docking station after the cells have been loaded with the medicaments.

CROSS REFERENCE TO RELATED APPLICATION

This application is a divisional of U.S. patent application Ser. No.12/033,957, filed Feb. 20, 2008, now U.S. Pat. No. ______, issued______. U.S. patent application Ser. No. 12/033,957 is incorporatedherein by reference in its entirety to provide continuity of disclosure.

FIELD

The field relates generally to item management and, more particularly,to item management providing for improved efficiency in itemdistribution.

BACKGROUND

Personnel involved in handling of items are routinely required to manageand organize the items for delivery to an appropriate user or process.An item as used herein, means or refers to a separate article, object,or product. Care is required to ensure that the correct item isdelivered to the user or process. Examples of such item-management tasksinvolve handling of medicament or nutriceutical items ultimatelyintended for use by a patient, consumer, or other user. A medicamentmeans or refers to a medication product while a nutriceutical canrepresent a dietary supplement which provides health or medicalbenefits. (e.g., a vitamin, a mineral, or a supplement.)

Items such as medicaments and nutriceuticals are provided in variousphysical forms, such as solid or substantially solid forms, granularforms, gel forms, and liquid forms. Solid or substantially solidmedicament and nutriceutical items may be shaped into small solidtablets in the physical form of capsules, spheres, ovals, disks,multi-angles, squares, triangles, and ellipses. Gel, granular, orliquid-form items may be packaged in the form of small capsules and gelcaps (for oral consumption), or ampules containing a liquid. Medicamentand nutriceutical items may also be provided which differ in strength ofthe active chemical constituent. For example, a single medicament ornutriceutical item may be provided with a concentration of 1, 5, or 10milligrams of the active chemical constituent.

One way in which the foregoing types of items are managed for deliveryto the ultimate user is through automated dispensing machines. Automateddispensing machines are frequently utilized by pharmacies, hospitals,long-term care facilities, and others in the health-care field forpurposes of automatically dispensing medicaments required to fulfillpatient prescription orders and to dispense medicaments administered topatients in hospitals and long-term care facilities, such as nursinghomes. Automated dispensing machines can also be used in retaildistribution, such as to dispense nutriceutical or food items. Suchautomated dispensing machines are computer controlled to dispense anappropriate quantity of medicaments and, typically, to package themedicaments. And, automated dispensing machines can typically beprogrammed to dispense and package all medicaments required to fulfillall prescription orders and dispense requests for a given eight-hourwork shift. The automated dispensing machine will proceed toautomatically execute the instructions until all requested medicamentshave been output.

Automated dispensing machines typically store and dispense a pluralityof different medicament types. Medicaments which are frequentlyprescribed or utilized, referred to as “fast-moving” medicaments, arestored within the automated dispensing machines in large quantities asloose, bulk form items within cassettes, cells, canisters, magazines,racks, or other storage apparatus. A single medicament type is stored ineach storage apparatus.

Medicaments which are less frequently prescribed or utilized arereferred to as “slow-moving” medicaments. Medicament types which areinfrequently required may be stored in the automated dispensing machinein what is referred to as an “exception storage apparatus,” a type ofstorage apparatus which derives its name merely from being analternative to the medicament storage apparatus used for the fastermoving medicaments. Slow-moving medicaments could include medicamenttypes with unusual chemical constituents or with unusualactive-constituent concentrations. An exception storage apparatus storessmall quantities of the less-frequently used medicaments which could notbe efficiently stored in large bulk quantities. Unlike the cassettes,cells, canisters, magazines, racks, or other storage apparatus for thefaster moving medicaments, more than one medicament type can be storedin a single exception storage apparatus.

An exception storage apparatus can be provided, for example, as adrawer, or as a tray-like device, which pulls out from the automateddispensing machine and which includes a plurality of medicament-holdingcells, or compartments, for holding one medicament item or a smallquantity of medicaments. In certain automated dispensing machine types,the cells of the exception storage apparatus are movable along a track.The cells can be indexed forward along the track toward an opening sothat the cell contents fall serially (i.e., one-after-the-other) througha cell bottom opening for packaging by the machine. Any number of cellscan be provided in the exception storage apparatus. For example, anexception storage apparatus could include 64 total cells grouped in fourrows of 16 cells all movable along the track. More than one exceptionstorage apparatus may be provided.

The exception storage apparatus offers the operator an opportunity toincrease the range of dispensing options because more than one type ofmedicament can be stored in such storage apparatus. For example, themedicaments can be arranged in the exception storage apparatus todispense medicaments for a particular patient according to the order inwhich the medicaments are to be taken by the patient (e.g., breakfast,lunch, and dinner) or can be loaded to meet the medicament requirementsof more than one patient.

Upon activation, the automated dispensing machine automatically metersout from the appropriate storage apparatus the desired quantity ofmedicament(s) called for by the prescription order or dispense request.The medicament item or items are directed from the storage apparatus tothe packaging apparatus by means of gravity through a chute or otherguide apparatus, or by mechanical means such as an auger. The packagingdevice may then load the dispensed medicaments into one or morepackages. The type of package utilized is based on the capability of theparticular type of automated dispensing machine. By way of example only,automated dispensing machines may load the medicaments into containerssuch as vials, bottles, blister packages, or pouch packages. Themedicament or medicaments, once packaged in the container type utilizedby the automated dispensing machine, may then be delivered to thepatient or other designated user.

Loading or replenishment of the cassettes, cells, canisters, or otherstorage apparatus for the fast moving medicaments is relatively easy.All that is required is placement of a loaded storage apparatus into themachine (e.g., in place of a depleted storage apparatus) or the pouringof a quantity of the bulk-form medicaments into a depleted storageapparatus.

However, loading or replenishment of the cells or compartments of theexception storage apparatus is more problematic because a human beingmust manually load or replenish the cells or compartments. In apharmacy, hospital, or long-term care facility, the human is a pharmacytechnician or a registered pharmacist. The technician or pharmacist mustmanually load the medicament items directly into the exception storageapparatus cells. Alternatively, the medicament items can be placed intothe cells of a “loading device.” A loading device is a device with cellsor compartments that correspond to the cells of the exception storageapparatus. The loading device can be loaded at a workstation and carriedto the automated dispensing machine so that the medicament contents ofthe loading device can be transferred into the appropriate cells of theexception storage device. By way of example only, a busy pharmacy mightuse dozens of different loading devices to load the exception storageapparatus during a given work shift.

The exception storage apparatus loading process is tedious and timeconsuming, irrespective of whether the medicament items are placeddirectly into the exception storage apparatus cells or are placed intothe cells of a loading device for transfer to the exception storageapparatus. As can be appreciated, the loading process must be undertakenin a deliberate and considered manner to ensure that the correctmedicament is placed in the correct cell or compartment. Placement ofthe correct medicament in the correct cell or compartment can bedifficult because the cells or compartments of a typical exceptionstorage apparatus or loading device are relatively small and are inclose proximity to each other. The chance of an inadvertent error may beincreased because certain medicaments have similar shapes, sizes, andappearances.

Typically, printed paper instructions are generated which direct thetechnician or pharmacist to place the required medicament into adesignated cell or compartment. At a minimum, valuable time is requiredto follow the instructions. The instructions may require complexordering of different medicament types among the cells raising thepossibility, no mater how slight, that the wrong medicament could beplaced in a cell or compartment. And, because the technician orpharmacist must take her eyes off the exception storage apparatus orloading device to read the instructions, and because the cells typicallylook alike, there is also a slight possibility that the wrong medicamentitem could be placed in the cell. And, since more than one loadingdevice could be used by a pharmacy, there is a possibility, no matterhow remote, that an incorrect loading device could be used to load theexception storage apparatus.

If a pharmacist is required to inspect a loading device or exceptionstorage apparatus before use to verify that the medicaments were loadedcorrectly, then the pharmacist must essentially repeat the loadingprocess to confirm that the correct medicament was received in thecorrect cell.

A skilled pharmacist's time is extremely valuable. Time spent loading anexception storage apparatus is time that could be spent counselingpatients. And, an automated dispensing machine must typically bedeactivated or taken “off line” in order to load the exception storageapparatus. Any time spent loading an exception storage apparatus canrepresent lost productive time in which the automated dispensing machinecannot be used to fulfill prescription orders or dispense requests,thereby decreasing efficiency and increasing costs to the operator.

Problems similar to those described for operators of automatedmedicament dispensing machines can exist for operators of other types ofautomated dispensing machines in which both fast and slow moving itemsmust be dispensed from a single machine. For instance, the same issueswould face the operator of an automated dispensing machine used todispense nutriceutical products or other retail food products.

There is a need for an item-management system, apparatus and methodswhich would improve the item management and distribution process, whichwould facilitate more accurate item management and distribution, andwhich would reduce the time needed to manage items, thereby freeingpersonnel for other important tasks and improving the quality of carewhich can be offered.

SUMMARY

Item-management systems, apparatus and methods are described. Thesystems, apparatus, and methods facilitate management and organizationof items, such as medicaments. The systems, apparatus, and methods maybe used, for example, to ensure that the correct item is provided to auser or other process. The systems, apparatus, and methods are describedin the preferred context of management of medicament-type items but canhave application with respect to management of other items, such asnutriceuticals.

In embodiments, an item-management system comprises a holder havingplural cells, a docking station to which the holder is docked, at leastone indicator selectively-operable to indicate the cell of a dockedholder into which an item is to be received, and at least one controlleroperable to selectively operate each at least one indicator to indicatethe cell into which the item is to be received.

In embodiments, a holder for management of items comprises a bodydefining plural cells. Preferably, each cell has an inlet and an outlet.It is further preferred that at least one gate is mounted with respectto the body and each cell outlet. The preferred gate is movable betweena first position in which the cell outlet is closed to receive an itemin the cell and a second position in which the cell outlet is open todischarge the item from the cell. A preferred gate type is a shuttlemember. Preferably, the shuttle member includes a pull permitting useroperation of the shuttle member. In embodiments, the holder cells are inalignment with corresponding cells of an automated dispensing machineexception storage apparatus, thereby permitting rapid transfer ofmedicaments from the holder cells, preferably through the outlets, andto the automated dispensing machine.

At least one indicator proximate each cell is selectively operable toindicate the cell into which an item is to be received. The indicatorscan also be used for verification that the correct item was placed intothe cell. Each at least one indicator provides visible information tothe technician, pharmacist or other user, freeing personnel fromreliance on written instructions regarding the medicament or other itemto be placed in each holder cell. In embodiments, each at least oneindicator is a lamp. Preferably, each lamp is a light-emitting diode,also known as an LED. In embodiments, a plural-lamp indicator consistingof more than one indicator can be provided proximate each cell, forexample to provide different types of information. For example, eachindicator may indicate the quantity or type of medicament to be placedin each cell. Plural indicators with colors that differ, or a singlemulti-colored indicator, lamp, or LED may be used, also to communicateuseful information to the user.

In preferred embodiments, the indicators are associated with the holder.In other preferred embodiments, the indicators may be associated with aguide provided as part of the docking station. The preferred guide islocated above a holder docked at the docking station and includesopenings in registry with the holder cells. The indicators indicatewhich opening through which to place the medicament or other item toload the medicament or item into the appropriate holder cell.

In embodiments, a holder may be docked to a docking station by anelectro-mechanical connection between mating contacts on the holder anddocking station when a holder is docked. In other embodiments a holdermay be docked to a docking station by a wireless connection with, orwithout, direct physical contact between the holder and docking station.Each connection type enables the selective indicator operation. Apreferred holder body may include structure facilitating alignment ofthe holder and docking station for holder docking. In yet otherembodiments, a holder may be directly connected to a controller, withouta docking station. Preferred docking station embodiments may include avideo display operably connected to the at least one controller and aninput device (e.g., a keyboard and/or mouse) enabling a user to inputinformation to the at least one controller. Preferably, the videodisplay is operable to display information which indicates the cell intowhich each medicament is to be received.

Preferably, the at least one controller is operatively connected to eachat least one indicator when the holder is docked at the docking station.It is preferred that the at least one controller comprises a computerincluding a set of instructions operable to selectively operate each atleast one indicator. Most preferably, the at least one controllerfurther includes a programmable logic controller operatively connectedto the computer and the PLC selectively operates each at least oneindicator. In embodiments, the instructions may be operable toselectively operate the indicators to control loading of a medicamentinto a cell for a patient or for a plurality of patients. Theinstructions may be operable to store information about the medicamentloaded into each cell.

Methods for management of medicaments and items are shown and describedherein.

BRIEF DESCRIPTION OF THE DRAWINGS

Exemplary item-management systems, apparatus, and methods may beunderstood by reference to the following description taken inconjunction with the accompanying drawings, in which like referencenumerals identify like elements throughout the different views. Forconvenience and brevity, like reference numbers are used for like partsamongst the embodiments. The drawings are not necessarily to scale,emphasis instead being placed upon illustrating the principles of theinvention. In the accompanying drawings:

FIG. 1 is a perspective view of a representative holder docked at adocking station;

FIG. 2 is a schematic side sectional view of the representative holderand docking station taken along section 2-2 of FIG. 1;

FIG. 3 is a schematic top sectional view of a representative holderdocked at a docking station taken along section 3-3 of FIG. 1 withcertain holder portions cut away to facilitate understanding;

FIG. 4 is a top side view of the representative holder of FIG. 1;

FIG. 5 is a left side elevation view of the representative holder ofFIG. 1;

FIG. 6 is a schematic top sectional view of a representativewireless-type holder docked at a docking station taken along a section,such as section 3-3 of FIG. 1 with certain holder portions cut away tofacilitate understanding;

FIG. 7 is a perspective view of a further exemplary embodiment showing adocking station with a guide, and a holder docked at a docking station;

FIG. 8 is a schematic side sectional view of the further exemplarydocking station and guide taken along section 8-8 of FIG. 7;

FIG. 9 is a schematic top sectional view of the further exemplarydocking station and guide taken along section 9-9 of FIG. 7;

FIG. 10 is a top side view of the holder shown in FIGS. 7-9 shown apartfrom the docking station;

FIGS. 11A-11C are enlarged fragmentary views of region 11 of FIGS. 3, 6,and 9 provided to illustrate an alternative indicator embodimentcomprising a multi-colored lamp which may be used with the holders orguide of FIGS. 3, 6, and 9;

FIG. 11D is an enlarged fragmentary view of region 11 of FIGS. 3, 6, and9 provided to illustrate a further alternative indicator embodimentcomprising a tri-lamp indicator which may be used with the holders orguide of FIGS. 3, 6, and 9;

FIG. 12A is a schematic illustration of an exemplary system including adocking station and computer external to the docking station;

FIG. 12B is a schematic illustration of a further exemplary systemincluding a docking station and computer internal to the dockingstation;

FIG. 13 is a perspective view of a storage cabinet including fourrepresentative holders temporarily stored therein;

FIG. 14 is an exemplary log-on screen display;

FIG. 15 is an exemplary screen display for loading of a holder;

FIG. 16 is an exemplary screen display for verification of the itemsloaded in the holder;

FIG. 17 is an exemplary screen display for verification of the itemsloaded in the holder including a reference image of a medicament;

FIG. 18 is a perspective view of an exemplary automated medicamentdispensing machine with which the representative holders of FIGS. 1-10may be utilized;

FIG. 19 is a perspective view of the exemplary automated medicamentdispensing machine of FIG. 18, but with one exemplary exception storageapparatus in an outwardly-extended position ready to receivemedicaments;

FIG. 19A is an enlarged fragmentary view of a portion of the exemplaryexception storage apparatus of FIG. 19;

FIG. 20 is a perspective view of the exemplary automated medicamentdispensing machine of FIGS. 18 and 19 but with the representative holderof FIGS. 1-10 positioned on the exemplary exception storage apparatus;

FIGS. 21A-21C are schematic side sectional views of the representativeholder of FIGS. 1-5 and exception storage apparatus of FIGS. 19-20 takenalong section 21-21 of FIG. 20. FIGS. 21A-21C show an exemplary sequencefor loading the contents of the holder into the exception tray; and

FIG. 22 is an exemplary series of medicament-containing pouch packagesof the type produced by the automated dispensing machine of FIGS. 18-20.

While the systems, apparatus, and methods are susceptible to variousmodifications and alternative forms, specific embodiments thereof havebeen shown by way of example in the drawings and are herein described indetail. It should be understood, however, that the description herein ofspecific embodiments and methods is not intended to limit the inventionto the particular forms disclosed, but on the contrary, the intention isto cover all modifications, equivalents, and alternatives falling withinthe spirit and scope of the invention as defined by the appended claims.

DETAILED DESCRIPTION

Referring first to FIGS. 1-9 and 12A, there are shown embodiments of anexemplary system 10 for management of items. The embodiments aredescribed in the context of a preferred item-management system formanagement of medicament 11 items. System 10, preferably includes holder13, docking station 15 to which holder 10 may be temporarily docked, andcontroller 17 which may include one or more controls capable ofoperating system 10. The term “at least one controller,” therefore,means or refers to embodiments in which controller 17 includes one ormore controller components. Controller 17 may include componentsinternal and/or external to docking station 15. In a further exemplarysystem 10′ (FIG. 12B), controller 17 is illustrated as being entirelywithin docking station 15. System 10 may be configured and arrangedbased on the needs of the pharmacy, hospital, long-term care facility orother operator. While it is envisioned that embodiments of system 10 or10′ will be utilized in the health-care industry, it should beunderstood that such systems and others may have application in fieldsoutside of the health-care industry for dispensing of items other thanmedicaments 11.

Referring then to FIGS. 1-5, there is shown an exemplary holder 13 formanaging and organizing medicaments. A further exemplary holder 13′ isillustrated in FIG. 6. The word “holder” means or refers to apparatuswhich holds one or more items. Holder 13′ is a wireless-type holder butis otherwise identical to holder 13. For simplicity and brevity, likereference numbers of holder 13 and docking station 15 are used toidentify like parts of holder 13′ and docking station 15′ and thedescription of holder 13 and docking station 15 are incorporated byreference with respect to holder 13′ and docking station 15′.

Exemplary holder 13, 13′ has a tray-like appearance in that holder 13,13′ is a flat, shallow container used for carrying, holding, andorganizing items which are preferably medicaments 11. However, otherholder configurations may be utilized depending on the needs of theuser.

Exemplary holder 13, 13′ includes a body 19, a top and a bottom 21, 23,a front and a rear side 25, 27, and a left and a right side 29, 31.Holder 13, 13′ further includes cells, of which cell 33 isrepresentative. Each cell 33 is defined by a wall 35, of which wall 35is representative. For purposes of simplicity and brevity, each cell 33of holder 13, 13′ is indicated by reference number 33 and each wall isindicated by reference number 35.

Each wall 35 defines a cell 33 upper opening, or inlet 37, and a celllower opening, or outlet 39. As shown in the examples, the cell inlets37 extend through, and are included in and along, the body top 21 whilethe cell outlets 39 extend through, and are included in and along, thebody bottom 23. In the embodiments, medicaments 11 are loaded into eachcell 33 through inlet 37 and are discharged from cell 33 through outlet39 as described in detail below.

In the embodiments, each cell 33 is identical and, as noted, referencenumber 33 indicates each identical cell 33. However, it is possible thatcells 33 of holder 13, 13′ may have a structure which is not identicaland which may differ depending on the needs of the user.

Referring to FIGS. 1-6 each exemplary holder 13, 13′ shown includessixty four total cells 33 organized into four rows of sixteen cells. Inthe examples, the organization of cells 33 is identical to theorganization of cells 41 of exception storage apparatus 43 shown pulledout from automated dispensing machine 45 in FIGS. 18-21C. Exemplaryholder 13, 13′ is configured and arranged such that each cell 33 outlet39 is in registry with (i.e., aligned with) a corresponding cell 41 ofexception storage apparatus 43 permitting direct movement of medicaments11 from holder 13, 13′ into exception storage apparatus 43 as shown inthe example of FIGS. 21A-21C.

Holder top 21 is preferably provided with human-readable indicia 47identifying each cell 33. In the examples, indicia 47 is an integer from1 to 64 proximate each cell 33. Other types of indicia 47 may be used,such as alpha-numeric indicia.

Holder 13, 13′ further includes at least one indicator 49 for each cell33, of which indicator 49 is representative. For purposes of simplicityand brevity, each indicator of holder 13, 13′ is indicated by referencenumber 49. An indicator 49 is located on holder 13, 13′ top side 21 nextto each cell 33. Each indicator 49 could be located inside body 19 ifbody is translucent. One indicator 49 is provided for each cell 33 for atotal of sixty four indicators 49 in these examples. Each indicator 49may be a visible indicator in the form of a selectively-operable lamp(i.e., an artificial light source). Energizing of each lamp-typeindicator 49 indicates the cell 33 into which the medicament 11 or otheritem is to be loaded. Preferably, each indicator 49 is a light-emittingdiode (LED), although it is envisioned that other types of lamp-typeindicators 49 may be used.

Controller 17 is operable to selectively operate each indicator 49 whenholder 13 is docked at docking station 15. Selective operation of anindicator 49 proximate to a cell 33 prompts the technician or pharmacistto place each medicament 11 into the cell 33 associated with theactivated indicator 49 or indicators 49. Collectively, the indicators 49comprise a type of pick-to-light system. Thus, if a medicament 11 is tobe loaded in the cells 33 designated by human-readable indicia 47 ascells 1, 3, 6, 9, 12, 15, 18, 21, 24, and 27, each of the indicators 49next to such cells 33 may be activated communicating to the technicianor pharmacist the specific cells 33 which should contain that medicament11. Use of a pick-to-light system of indicators 49 advantageouslycommunicates information to the technician or pharmacist without resortto a set of written instructions. A pick-to-light system is far superiorto written instructions because the person responsible for loading orverification of holder 13, 13′ need not take his or her eyes off ofholder 13, 13′ to read the instructions thereby increasing accuracy andreducing the time required to load or verify the medicaments 11 thatshould be in the holder 13, 13′.

As illustrated in yet a further embodiment illustrated in FIGS. 11A,11B, and 11C, indicator 49 could comprise a single multi-coloredindicator 49 for each cell 33. For example a multi-colored LED lampcould be used as indicator 49. As is known, changing the voltage to amulti-colored LED or selectively activating one of plural LED anodescauses the LED to emit a different color as represented in FIGS.11A-11C. Each different color can be used to communicate a differenttype of information to the technician loading the holder 13, 13′. Forexample, a red color signal from indicator 49 (FIG. 11A) could indicatethat one medicament 11 is to be loaded into that cell 33. A green-colorsignal from indicator 49 (FIG. 11B) could indicate that more than onemedicament 11 is to be loaded in that cell 33. A yellow-color signalfrom indicator 49 (FIG. 11C) could indicate that a half-size medicamentis to be loaded in that cell 33.

A further indicator 49 embodiment is illustrated in FIG. 11D. In theexample of FIG. 11D, a plural-lamp indicator 49 could be provided foreach cell 33 for purposes of communicating information to the technicianor pharmacist. In FIG. 11D, a plural-lamp indicator 49 consisting ofthree lamps is provided adjacent each cell 33. Any number of lamps couldbe used. Each lamp of indicator 49 could, for example, consist of an LEDlamp of a different color, such as red 49 a, green 49 b, or yellow 49 c.Each color could indicate a different type of information as describedin connection with the multi-colored LED example of FIGS. 11A-11C.Energizing of only the red-color indicator 49 a could indicate that onemedicament 11 is to be loaded into that cell 33. Energizing of only thegreen-color indicator 49 b could indicate that more than one medicament11 is to be loaded in that cell 33. Energizing of only the yellow-colorindicator 49 c could indicate that a half-size medicament is to beloaded in that cell 33. Alternatively, the lamps may all be of the samecolor and the number of activated indicator lamps 49 proximate each cell33 could indicate the quantity of medicaments to be placed in each cell33. Alternatively, the indicator 49 could have a blink patternindicating the medicament 11 to be loaded into the cell 33. A constantblink could indicate that one medicament 11 is to be loaded into thecell, two blinks could indicate that more than one medicament 11 is tobe loaded in that cell 33, and three blinks could indicate that ahalf-size medicament is to be loaded in that cell 33. Operation of theindicators 49 as described can also be used for verification ofmedicaments received in each cell 33.

Holder 13, 13′ further includes a pair of legs 51, 53 depending fromholder 13, 13′ bottom side 23. Legs 51, 53 may be provided to supportholder 13 on a surface (such as counter top 85). Referring to FIGS. 1and 5, bottom side 23 may extend outwardly from holder sides 29, 31 fora purpose described below.

Referring to FIGS. 1-6 and 21A-21C, exemplary holder 13, 13′ furtherincludes a planar shuttle member 55 positioned in planar track 57 inholder proximate each cell 33 outlet 39. Shuttle member 55 includesopenings 59 and a pull 61 which permits the technician or pharmacist tograsp shuttle member 55 with his or her hand and to pull or push shuttlemember 55.

In the example, shuttle member 55 is movable between a first position inwhich shuttle member 55 covers and closes each cell 33 outlet 39 asshown in FIG. 21A and a further position in which the shuttle member 55openings 59 are in alignment with each cell 33 outlet 39, therebyopening each cell outlet 39 permitting medicaments 11 to drop from eachcell 33 into a corresponding cell of exception storage apparatus 43 asshown in FIG. 21C. The first position of shuttle member 55 is referredto herein as a “cell-closed position” and the further position ofshuttle member 55 is referred to herein as a “cell-opened position.” Inbetween these positions, the cells 33 are partially open permittingmedicaments to start to fall from cells 33 as shown in FIG. 21B.

In the embodiments, shuttle member 55 serves as a gate, opening andclosing each cell 33 as shuttle member 55 moves between the cell-closed(FIG. 21A) and cell-opened positions (FIG. 21C). Shuttle member 55thereby blocks each cell outlet 39 in the cell-closed positionpermitting a medicament 11 to be loaded into each cell 33 for organizingand storage and further opens each cell outlet 39 permitting eachmedicament 11 to be discharged from holder 13, 13′ for loading intoexception storage apparatus 43 as described below.

Referring to FIG. 3, holder 13 and docking station 15 may includestructure configured to enable or facilitate docking of holder 13 withdocking station 15. In the embodiment, holder 13 is provided with afemale alignment pin receiver 63 and docking station 15 is provided witha male alignment pin 65 which is inserted into and seated in receiver 63when holder 13 is docked with docking station 15. The mechanicalinterconnection of receiver 63 and pin 65 properly locates holder 13 atdocking station 15. A contact-switch-type proximity detector 66 may beprovided to indicate to controller 17 that holder 13 is properly dockedat docking station 15. Holder 13′ and docking station 15′ may beprovided with receiver 63, pin 65, and detector 66.

FIGS. 1-5 and FIG. 6 are provided to show exemplary types of connectionsbetween a holder and a docking station. Referring first to FIGS. 1-5, anexemplary electro-mechanical connection between holder 13 and dockingstation 15 is shown. In the example, holder 13 body 19 is provided witha pair of electrical contacts 67, 69 permitting control over operationof indicators 49 through docking station 15 and controller 17. Twocontacts 67, 69 are not required as any number of contacts will suffice.When holder 13 is properly docked with docking station 15, contacts 67,69 are brought into operable connection with corresponding contacts 71,73 on docking station. Contacts 71, 73 are connected by suitableelectrical conductors 75, 77 to programmable logic controller 79 ofcontroller 17. Contacts 67, 69 are operably connected to indicators 49through appropriate conductors (not shown) permitting selectiveenergizing and operation of indicators 49 to indicate the cell 33 intowhich each medicament 11 is to be loaded. Examples of representativecontacts 67, 69, 71, 73 for a holder 13 with sixty four indicators 49are Amplimite™ 37 position, size 4 HD-20 male and female contactsavailable from Tyco Electronics of Harrisburg, Pa.

Referring now to FIG. 6, the holder 13′ embodiment shown thereinincludes structure enabling wireless connection between holder 13′,docking station 15,′ and controller 17. Holder 13′ includes a controlcircuit board 68, with a wireless transmitter/receiver 70 powered by abattery 72 associated with holder 13′. Board 68 is operably connected toindicators 49 through appropriate conductors (not shown) permittingselective energizing and operation of indicators 49 to indicate the cell33 into which each medicament 11 is to be loaded or to permitverification of medicaments 11 received in cells 33.Transmitter/receiver 70 sends and receives signals with docking station15′ transmitter/receiver 74 permitting selective operation of indicators49 through docking station 15′ and controller 17.

In the examples of FIGS. 1-5 and FIG. 6, exemplary holder 13, 13′ anddocking station 15, 15′ are provided with apparatus 81, 83 for uniquelyidentifying holder 13, 13′ to docking station 15, 15′ and system 10 or10′ as shown schematically in FIG. 3. Positive identification of holder13, 13′ enables the user to precisely control loading of appropriatemedicaments 11 into holder 13 and 13′ permits the user to maintain moreaccurate records of medicaments 11 which have been dispensed. In suchembodiments, holder 13, 13′ may include an identification element 81 anddocking station 15, 15′ may include an identification element detector83 as shown in FIG. 3. The identifier element 81 may, for example,consist of a radio frequency identification tag (RFID) and the detector83 may be an RFID tag reader (i.e., an interrogator) on docking station15. The exemplary RFID tag 81 may be re-writable or read-only, asdesired. Exemplary RFID reader 83 provided on docking station 15, 15′detects information embedded on the RFID tag 81. Information embedded inRFID tag 81 identifying holder 13, 13′ may be used by system 10, 10′ tocontrol the medicament-dispensing process.

An identification element detector 84 may be provided on automateddispensing machine 45 (FIGS. 19, 20). In the example utilizing RFIDtags, detector 84 may comprise an RFID reader. If the correct holder 13,13′ identification element 81 is detected by detector 84, the technicianor pharmacist is prompted to transfer medicaments 11 from holder 13, 13′to exception storage apparatus 43. Conversely, if an incorrect holderidentification element 81 is detected by detector 84, the technician orpharmacist is prompted to not load the exception storage apparatus 43.

Holder 13, 13′ may be made of any suitable material or combination ofmaterials. Preferably, body 19 is made of plastic material constructionfor reasons of ease of manufacture, low weight, ease of cleaning, andcost. Indicators 49 are preferably LED-type lamps but may comprise othertypes of visible indicators.

Referring next to FIGS. 1-3, and 6 there are shown embodiments ofdocking stations 15, 15′ capable of use with a respective exemplaryholder 13, 13′. Each docking station 15, 15′ may be placed on a countertop 85, such as the counter top 85 at a workstation in a pharmacy,long-term care facility, hospital, or other facility. A mounting bracket87 may be provided to mechanically secure docking station 15, 15′ tocounter top 85.

Each exemplary docking station 15, 15′ preferably includes housing 89including top and bottom walls 91, 93, left and right side walls 95, 97and front and rear walls 99, 101. Indicator 102 is provided on frontwall 99. Indicator 102 is preferably an LED lamp which is activated if aholder 13 is properly docked at docking station 15, 15′ and isrecognized as an authorized holder 13 by system 10, 10′ by means ofidentifier element 81.

In the embodiments of FIGS. 1-3 and 6, housing 89 encloses aprogrammable logic controller (PLC) 79 and a power supply 103. In suchembodiments, PLC 79 is a component of controller 17. Power-supply port105 is provided for connection to a suitable 120 Volt electrical powersource by means of an electrical cord (not shown) to supply electricalpower to PLC 79. PLC 79 includes instructions permitting selectiveclosing and opening of relays within PLC 79 corresponding to theindicator(s) 49 of holder 13, 13′ which are to be selectively operatedto indicate the cell 33 into which each medicament 11 is to be placed.Power supply 103 preferably provides 5 Volt DC power to selected ones ofLED-type indicators 49 once the appropriate relays of PLC 79 areselectively closed, thereby providing selective energizing and operationof indicators 49. In embodiments utilizing a multi-color LED-typeindicator 49 (FIGS. 11A-11C) PLC 79 may also regulate the voltage toeach indicator 49 or selectively energize the anodes to change the coloremitted by the multi-colored LED. In wireless holder embodiments 13′,control circuit board 68 (e.g., a controller on board 68) activatesindicator 49 responsive to signals generated by PLC 79 totransmitter/receiver 74. An exemplary PLC 79 suitable for use as acomponent of controller 17 is a Model 06 Koyo Electronics PLC availablefrom Automation Direct, Inc. of Cumming, Ga.

Referring to the embodiment of FIG. 12A, system 10 may include a server107 operably connected to PLC 79 via data port 109 and communicationlink 111. In the embodiment, controller 17 includes both PLC 79 andserver 107 operatively connected thereto. Server 107 may include memory113 with a program of instructions 115 residing in memory 113. Server107 is representative of any data management system operated by apharmacy, hospital, long-term care facility, or other operator forpurposes of managing information related to dispensing of medicaments11. Communication link 111 may be any link capable of transmitting dataand other information. Link 111 may, for example, comprise a dedicatedland line, wireless link, ethernet, internet, intranet, local areanetwork (LAN), or other suitable connection enabling data transmissionbetween PLC 79 and server 107. Server 107 is preferably an off-the-shelfcomputer representative of any suitable data-management controller. Itis envisioned that holder 13 can be connected directly to server 107without a docking station 15, for example through a suitablecommunication link.

In a further illustrative embodiment represented by FIG. 12B, system 10′includes an on-board computer 117 within docking station 15, 15′ housing89 and computer 117 serves as controller 17. Computer 117 includes aprogram of instructions 119 residing in memory 121 which are operable toselectively energize and operate the indicators 49 to indicate the cell33 into which one or more medicament(s) is/are to be placed. In thisembodiment, computer 117 is linked to automated dispensing machine 45via communication link 123 and server 124. Communication link 123 may beof the type as described previously in connection with link 111 andserver may be a pharmacy information system server provided to managepharmacy workflow generally. Overall activation of indicators 49 isprovided by computer 117 in this example. System 10′ is otherwiseidentical to system 10 and the description of system 10 is incorporatedby reference with respect to system 10′.

Each docking station 15, 15′ further preferably includes a video display125, keyboard 127, and mouse 129 permitting a technician or pharmacistto input and receive information from server 107 or computer 117 ofcontroller 17. A biometric identification device 130 may be provided topermit the technician or pharmacist to be identified to the system 10 or10′, particularly when logging on to the system. The biometric device130 may be a fingerprint reader, retina scanner, or other suitabledevice. A bar code scanner 131 is preferably operably connected tocontroller 17. Video display 125 is preferably a touch screen displaypermitting a technician to input information to controller 17 by simplytouching her finger on a desired portion of the display 125. Bar codescanner 131 may be any off-the-shelf scanner capable of reading a barcode 133 on a container 135 provided to hold medicaments 11. Keyboard127 may be an off-the-shelf QWERTY-type keyboard 127 permitting atechnician to input information to controller 17 and system 10, 10′.

FIGS. 7, 8, 9, and 10 illustrate a further holder 13″ and dockingstation 15″ embodiment suitable for use with an item-management system,such as system 10 or 10′. For simplicity and brevity, like referencenumbers of holders 13, 13′ and docking stations 15, 15′ are used toidentify like parts of holder 13″ and docking station 15″ and thedescription of holders 13, 13′ and docking stations 15, 15′ areincorporated by reference with respect to holder 13″ and docking station15″. The embodiment of FIGS. 7-10 differs from the embodiments of FIGS.1-6 because the indicator or indicators 49 which areselectively-operable to indicate the holder cell 33 into which an itemis to be loaded are located on a guide 136 associated with dockingstation 15″. Use of guide 136 with indicators 49 located thereon enablesuse of the item-management system with a holder 13″ which does notinclude indicators 49 thereon, typical of holders presently in use.

Referring further to FIGS. 7-10, holder 13″ includes body 19, top andbottom sides 21, 23, sides 25-31, cells 33 (including inlet and outletopenings 37, 39), legs 51, 53, shuttle member 55. An identificationelement 81 of the type previously described is preferably provided onbody 19. An alignment pin receiver 63 may be provided to receive pin 65of docking station 15″ to position holder 13″ at docking station 15″.Exemplary docking station 15″ includes detector 83, housing 89 withwalls 91-101, lamp 102, power supply 103, and ports 105, 109, and isprovided with a video display 125, keyboard 127, mouse 129, biometricidentification device 130, and bar code scanner 131 for the purposesdescribed in connection with docking stations 15, 15′.

Docking station 15″ includes a guide 136 attached to housing front wall99. Guide 136 is preferably a planar member located in a plane above aholder 13″ docked at docking station 15″ beneath guide 136. Guide 136 isprovided with openings, each of which is identified by reference number138 for brevity. In the example, guide 136 is provided with 64 totalopenings 138 grouped in four rows of openings 138. This opening 138pattern is identical to the pattern of cells 33 in holder 13″. Thisopening 138 pattern is such that the openings 138 in guide 136 are inregistry and alignment with the corresponding cells 33 of holder 13″when holder 13″ is docked at docking station 15″. This arrangementallows a technician to rapidly and accurately load each cell 33 ofholder 13″ by inserting a medicament through the appropriate opening 138in guide and into the corresponding cell 33 during holder 13″ loading.

Indicators 49 on guide 136 are proximate each opening 138 to indicate tothe technician, upon activation, which opening 138 a medicament 11 orother item is to be inserted. Indicators 49 may, for example, be asingle lamp (preferably an LED) as illustrated in FIGS. 1, 3-4, 6-7, and9, a multi-colored LED as illustrated in FIGS. 11A-11C, or pluralindicators 49 as illustrated in FIG. 11D, or another indicator type.Human-readable indicia 140 is preferably provided on guide 136 so thateach opening 138 on guide 136 has the same indicia 140 as indicia 47,211 on holder 13″ and exception storage apparatus 43. Indicia 140further assists the technician to ensure that the correct medicament 11is loaded into the correct guide 136 opening 138. Guide 136 indicators49 are connected to PLC 79 through appropriate conductors (not shown)permitting selective energizing and operation of indicators 49 toindicate the opening 138 through which each medicament 11 is to beloaded. Guide 136 may be made of any suitable material such as metal,plastic, laminate or a combination of materials.

Docking station 15″ is otherwise identical to docking station 15previously described and illustrated and the description of dockingstation 15 is incorporated by reference. Controller 17, as previouslydescribed, controls operation of docking station 15″ and indicators 49on guide 136 and holder 13″, docking station 15″, and controller 17 maybe used as part of an item-management system, such as system 10 or 10′(FIGS. 12A, 12B).

FIGS. 14-17 are exemplary screen displays of a type which could bedisplayed to a technician or pharmacist on display 125 for purposes ofimplementing system 10 or 10′ using holder 13, 13′, or 13″ and dockingstation 15, 15′, or 15″. The screen displays of FIGS. 14-17 are intendedto represent non-limiting examples as the type and number of screendisplays can be modified and the information provided in the screendisplays may be customized to meet the needs of the particular pharmacy,hospital, long-term care facility or other operator. For convenience andbrevity, the screen displays of FIGS. 14-17 are described in connectionwith system 10 including holder 13 and docking station 15, it beingunderstood that the screen displays and methods of implementing system10 are applicable for use with system 10′ or with holder 13′, 13″ anddocking station 15′, 15″.

Referring to the screen displays of FIGS. 14-17, a technician orregistered pharmacist initiates use of system 10 by logging on to thesystem 10, preferably at docking station 15. Preferably, loading ofholder 13 is performed by a technician while verification of the loadedholder 13 is performed by a registered pharmacist.

Referring to FIG. 14, the technician is initially presented with alog-on screen 137 displayed on video display 125. The technician logs onto the system 10 by keying his or her password into the password field139 using keyboard 127 and selecting the ENTER icon 141. Alternatively,the technician could utilize biometric device 130 to identify herself tothe system 10. The technician's password information is transmitted toserver 107 (or server 124 in system 10′), whereupon it is determinedthat the technician is an authorized user.

If a holder 13 is not already docked at docking station 15 as shown inFIGS. 1-3 (or is not in wireless communication with docking station 15′as in FIG. 6), a further screen (not shown) may be displayed on videodisplay 125 prompting the technician to dock a holder 13 at dockingstation 15. In the example of FIGS. 1-3, holder 13 is shown docked atdocking station 15 by insertion of pin 65 in receiver 63, therebypositioning holder 13 to form an electrical connection between holdercontacts 67, 69 and docking station contacts 71, 73. Identificationelement detector 83 identifies the unique identifier element embedded inholder 13. Detector 83 preferably detects an RFID-type identificationelement 81 to identify holder 13 to system. If the docked holder 13 isrecognized by system 10 (or if wireless-type holder 13′ is recognized bysystem 10), indicator lamp 102 is activated to inform the technicianthat the system 10 is in a ready state. Proximity detector 66 may alsoindicate to controller 17 that holder 13 is properly docked at dockingstation 15.

Referring next to FIG. 15, if the technician is authorized and if holder13 is docked and recognized, then a holder-loading screen 143 isdisplayed on video display 125. Holder-loading screen 143 providesinformation for loading each medicament 11 into the correct cell 33.

Information which may be presented on holder-loading screen 143 caninclude an identification field 145 identifying the operator name (e.g.,Nowtime Pharmacy), technician name, and date and time-of-day on whichholder 13 is being loaded. Additional information which may be displayedin connection with screen 143 is the holder identifier 147 andtransaction code 149 which indicates the transaction corresponding toloading of the holder 13 for record-keeping purposes. Preferably, thetransaction number and all other information relating to loading andverification of holder 13 is stored in a database on server 107 or 124.Holder identifier 147 may be any symbol or group of symbols capable ofdistinguishing one holder 13 from another holder 13. In the example,holder identifier 137 is identical to the identifier embedded in RFIDtag-type identification element 81. In the example, the holderidentifier 147 is the number 2. A unique identifier 147 can be importantif more than one identical holder 13 is used by the pharmacy, hospital,long-term care provider or other operator.

Referring further to FIG. 15, holder-loading screen 143 includesinformation 151 required for loading of cells 33 of holder 13.Preferably, information 151 is displayed in the form of a graphical userinterface (GUI), thereby facilitating ease of use by the technician. Inthe example, information 151 includes a select field 152, a celllocation field 153, a medication type field 155, a dosage strength field157, an NDC number 159 field, a shelf location 161 field, and a status163 field. In the example, information 151 is displayed for eachmedicament 11 to be loaded into holder 13. In the example of FIG. 15,three medicament 11 types, namely, Cardura tablets, Azithrmycin tablets,and Coumadin tablets are to be loaded into holder 13.

The cell location field 153 identifies the cell 33 into which medicament11 is to be loaded by referencing the human-readable indicia 47associated with the designated cell 33. In the example, Cardura tabletsare to be loaded into cells of holder 13 associated with thehuman-readable indicia 47 represented by numbers “1, 3, 6, 9, 12, 15,18, 21, 24, 27” while the other medicaments are to be loaded into theother cells 33 of holder 13 identified in the cell location field 153.The ordering of the medicaments 11 is determined by the order in whichthe medicaments 11 are required in order to load each container orcontainers (e.g., a vial, bottle, blister package, or pouch package) foreach prescription order or dispense request. For example, server 107 mayorder the medicaments 11 presented on screen 143 based on the sequencein which prescription orders or dispense requests are to be filled formore than one patient or may order the medicaments 11 presented onscreen 143 based on a drug regimen for a single patient, for example,ordering the medicaments by the time of day the medicaments 11 are to betaken by the patient (e.g., breakfast, lunch, and dinner). The slowmover medicaments 11 indicated on screen 143 may be arranged and orderedfor serial dispensing (i.e., one-after-the-other) or may be arranged andordered to alternate with medicaments dispensed from other storageapparatus (e.g., cassettes, cells, canisters, etc.) within automateddispensing machine 45.

The medication type field 155 and dosage strength field 157 informationrefers to the type and strength of the medicament 11, while the NDCnumber field 159 information refers to the 10-digit National Drug Code(NDC) number for the specific medicament 11 called for by theprescription order or dispense request.

The shelf location field 161 information refers to the shelf location ofthe pharmacy, hospital, long-term care facility, or the like at whichthe medicament container, for example representative container 135 (FIG.1), holding a medicament 11 is located. This information is provided toassist the technician in retrieving the container 135 from storage. Inthe example, fictitious alpha-numeric shelf locations are displayed.

As illustrated in FIGS. 1 and 7, it is envisioned that the technicianwill scan the bar code 133 on the container 135 with bar code scanner131. Program of instructions 115 running on server 107 can then verifythat the correct container 135 has been selected from storage based oninformation contained in bar code 133. The technician can also verifythat the correct medicament container 135 has been selected by comparingthe medication type 155, strength 157, and human-readable NDCinformation 159 on the screen 143 with human-readable information on thelabel for container 135.

The status information field 163 indicates the status of theholder-loading process. Selection of each medicament 11 for loading canbe made simply by touching the technician's finger on the row 165 oftouch-screen video display 125 associated with one medicament 11 or byselecting the row 165 with another input device, such as keyboard 127and mouse 129. In the example of FIG. 15, the technician is in theprocess of loading Cardura tablets into cells 33. This is indicated bythe row 165 associated with Cardura tablets having been selected asindicated by the X character in the select field 152 and the IN-PROCESStext in status information field 163. The row 165 associated with theAzithrmycin tablets indicates FILLED in the status information field 163indicating that loading of the Azithrmycin tablets has been previouslycompleted. The row 165 associated with the Coumadin tablets has not yetbeen selected as indicated by the UNFILLED indication in field 153.

PLC 79 (or computer 117 in system 10′) selectively activates theindicator 49 for each cell 33 into which the medicament 11 is to beloaded once the appropriate row 165 associated with the medicament isselected. This pick-to-light feature enables the technician to loadmedicaments 11 without any necessity for reliance on written loadinginstructions. Thus, in the example of FIG. 15, the indicator 49,preferably an LED lamp, associated with each of cells 33 indicated bythe human-readable indicia 47 “1, 3, 6, 9, 12, 15, 18, 21, 24, 27” isenergized to tell the technician to load a Cardura tablet into each ofthese cells 33. Each indicator 49 associated with each other cell 33 ofholder 13 is not activated. Activation of only each indicator 49associated with the cell to be loaded is referred to herein as selectiveindicator 49 activation or operation.

Once all cells 33 associated with a row 165 are filled, the technicianthen selects the next row 165 of medicaments to be filled and proceedsto load holder 13 as directed by indicators 49. Selection can again beaccomplished by touching the technician's finger on the row 165 oftouch-screen video display 125 associated with the next medicament 11 tobe loaded in holder 13 or by selecting the row 165 with the keyboard 127or mouse 129. The indicator or indicators 49 previously activated aredeactivated and the appropriate indicators 49 for the next medicament 11to be loaded are activated. This process is repeated until allmedicaments 11 have been loaded in holder 13 as called for by screen143.

Once all cells 33 of holder 13 are loaded as required by holder-loadingscreen 143, the technician clicks on, or otherwise selects, the HOLDERFILLED icon 167. Selection of icon 167 sends a signal to server 107 (orserver 124 in system 10′ indicating that loading of holder 13 has beencompleted. Each loaded holder 13 can subsequently be verified by aregistered pharmacist prior to loading of medicaments 11 from loadedholder 13 into automated dispensing machine 45.

Referring now to FIG. 13, a storage cabinet 169 may optionally beprovided to store one or more holder 13, 13 a, 13 b, and 13 c therebyfacilitating loading and verification of multiple holders. In theexample, each holder represented by reference numbers 13 a, 13 b and 13c has structure identical to holder 13. Loaded holders 13, 13 a, 13 b,and 13 c may be stored in cabinet 169 after loading and beforeverification or may be stored in cabinet 169 after verification by aregistered pharmacist and before loading of the verified medicaments 11into exception storage apparatus 43 of automated dispensing machine 45.

If provided, storage cabinet 169 includes top and bottom walls 171, 173,sidewalls 175, 177, and a front opening 179 through which holders (e.g.,holder 13) are placed into cabinet 169. Stacked opposed slot pairs181,183 may be provided to receive the bottom 23 of each holder 13permitting holders 13, 13 a, 13 b, and 13 c to be stored in cabinet 169.

As already noted, each loaded holder 13 can be verified by a registeredpharmacist to ensure that each cell 33 has been loaded with the correctmedicament 11. FIG. 16 shows an exemplary holder-verification screen 185which corresponds to the holder-loading screen 143 for that holder 13.Holder-verification screen 185 includes information 187 required forverification of the medicaments 11 loaded into cells 33 of holder 13.This information is essentially identical to that displayed inconnection with holder-loading screen 143. For convenience andsimplicity, reference numbers of information displayed on holder-loadingscreen 143 are used again to identify corresponding fields ofinformation on holder-verification screen 185.

As with the holder-loading screen 143, an identification field 145 canbe provided to identify the operator name (e.g., Nowtime pharmacy), nameof the pharmacist responsible for medicament 11 verification, and thedate and time-of-day on which holder 13 is verified. The holderidentifier 147 and transaction code 149 are also preferably displayedfor the same purpose as described in connection with the holder-loadingscreen 143.

Preferably, information 187 is again displayed in the form of agraphical user interface (GUI), thereby facilitating ease of use by theverifying pharmacist. In the example, the displayed information 187again includes a select field 152, a cell location field 153, amedication type field 155, a dosage strength field 157, an NDC numberfield 159, a shelf location field 161, and a status information field163 including the information described in connection withholder-loading screen 143. In the example, information 187 is againdisplayed for each medicament 11 to be loaded into holder 13. In theexample of FIG. 16, the Cardura tablets, Azithrmycin tablets, andCoumadin tablets previously loaded into cells 33 of holder 13 arepresented for verification by the pharmacist.

In order to verify that each cell 33 holds the correct medicament 11,the pharmacist simply selects the row 165 to be verified. Selection isaccomplished by touching the touch screen display 125 on row 165 or byselecting row 165 with the keyboard 127 or mouse 129. The statusinformation field 163 again indicates the status of theholder-verification process.

Referring further to FIG. 16, the screen display 185 shows an example ofdisplayed information for verification that the Cardura tablets havebeen correctly loaded into the cells 33 indicated by the human-readableindicia 47 “1, 3, 6, 9, 12, 15, 18, 21, 24, 27” located on holder 13.Selection of the Cardura tablets for verification is indicated in theexample by the row 165 associated with Cardura tablets having beenselected as indicated by the X character in the select field 152 and theIN-PROCESS text in status information field 163. The row 165 associatedwith the Azithrmycin tablets indicates VERIFIED in the statusinformation field 163 indicating that verification of the Azithrmycintablets has been completed. The row 165 associated with the Coumadintablets has not yet been selected for verification as indicated by theUN-VERIFIED indication in field 163. A selected row 165 can also behighlighted to facilitate identification of the row 165 then beingverified.

Referring next to FIG. 17, a further verification screen display 186 maybe provided to assist the pharmacist with the verification process. Aseach row 165 is selected, a medicament-specific verification screen 186may be displayed. In the example, screen 186 displays the row 165 beingverified including the cell location field 153, medication type field155, dosage strength field 157, NDC number field 159, shelf locationfield 161, and status information field 163. Screen 186 also displays areference image of the physical appearance of the medicament 188together with a word description 190 of the physical appearance of themedicament 11. In this example of the Cardura medicaments 11, the worddescription 190 is white oblong tablet. A screen display similar todisplay 186 of FIG. 17, including a reference image 188 and worddescription 190, may be displayed to the technician during theholder-loading process associated with screen 143 to assist thetechnician in placing the correct medicament(s) 11 into each cell 33.

Upon selection of a row 165, PLC 79 of controller 17 again selectivelyactivates each indicator 49, preferably an LED lamp, for each cell 33 tobe verified by the pharmacist. As with the loading process, thispick-to-light capability enables the pharmacist to rapidly confirm thatthe correct medicament 11 has been loaded into the correct cell 33without the necessity for reliance on written verification instructions.The pharmacist can quickly compare the physical appearance of eachmedicament 11 in each indicated cell 33 without the necessity ofreliance solely on written instructions. This process is facilitated bypresentation of screen 186 and the reference image and descriptioninformation 188, 190 as the pharmacist can quickly compare theappearance of the medicament 11 on screen 186 with the appearance of themedicament(s) 11 in each cell 33 associated with an activated indicator49.

Thus, in the verification example of FIGS. 16-17, each indicator 49associated with each of cells indicated by the human-readable indicia 47“1, 3, 6, 9, 12, 15, 18, 21, 24, 27” into which Cardura tablets was tobe loaded, is activated by PLC 79 of controller 17 (or computer 117 insystem 10′) during the verification process. Each other indicator 49 isinactive.

If screen 186 is provided, selection of the DONE icon 192 returns thepharmacist to screen 185 for selection of the next medicament 11 to beverified. Once all cells 33 associated with a row 165 are verified, thetechnician then selects the next row 165 of medicaments to be verifiedand proceeds to verify the medicament(s) in each cell 33 as directed byindicators 49. The indicator or indicators 49 previously activated aredeactivated and the appropriate indicators 49 for the next medicament 11are activated. This process is repeated until all medicaments 11 havebeen verified as called for by screen 185.

Once all rows 165 and medicaments 11 are verified, the pharmacistselects the HOLDER VERIFIED icon 189. Selection of icon 189 sends asignal to server 107 of system 10 (or server 124 of system 10′)indicating to system 10 that holder 13 has been fully verified and thatthe medicament 11 contents are in the correct cells 33 ready for usewith automated dispensing machine 45. A record may be made of theverified medicament 11 contents of holder 13 cells 33 which may bestored in a database residing on server 107 (or server 124). Such arecord is useful in further confirming that the correct medicaments 11were loaded in holder 13. Each verified holder 13 can then be stored incabinet 169 awaiting use, or the holder 13 and its medicament 11contents can be taken directly to automated dispensing machine 45 forimmediate loading of medicaments 11 into exception storage apparatus 43.

Referring now to FIGS. 18-20, there is shown an exemplary automateddispensing machine 45 and exception storage apparatus 43 which may bequickly and accurately loaded with medicaments 11 using holder 13 or 13′or 13″. Dispensing machine 45 includes a cabinet 191 with top and bottomwalls 193, 195 and left and right sidewalls 197, 199. A touch-screenvideo display 201 is mounted to sidewall 199. Display 201 includescontrols permitting a technician or pharmacist to control operation ofdispensing machine 45 and to receive information about the status of themedicament filling process.

Exemplary dispensing machine 45 includes twenty pull-out drawers ofwhich drawers 203 are exemplary. In the example, drawers 203 areorganized into five rows of four drawers 203. Each drawer 203 supports aplurality of removable cassette-type storage apparatus (not shown), eachof which stores a large quantity of bulk-form medicaments 11. Thecassettes can be replenished as medicaments 11 stored therein aredepleted.

Exemplary dispenser 45 further includes a pair of doors 205, 207 whichcover exception storage apparatus 43 as shown in FIG. 18 and which canbe opened as shown in FIGS. 19-20. As previously described, exceptionstorage apparatus 43 may be provided to store and to dispense “slowmover” medicaments 11 loaded therein. In the example, dispenser 45includes a single exception storage apparatus 43. However, any number ofexception storage apparatus 43 may be provided based on the needs of theoperator.

In the example, exception storage apparatus 43 is a drawer or tray-likedevice which can be pulled out from cabinet 191 as shown in FIGS. 19-20.When in the state of FIGS. 19-20, automated dispensing machine 45 istemporarily shut down and is out of service and unavailable to fillprescription orders and dispense requests while exception storageapparatus 43 is pulled out from cabinet 191. Therefore, it is importantto load exception storage apparatus 43 as promptly as possible to returndispensing machine 45 to service.

The exception storage apparatus 43 shown in FIGS. 19-20 can be describedas having a somewhat flat and narrow configuration with a plurality ofcells 41 provided therein. Each cell 41 of exception storage apparatus43 is capable of storing one medicament 11, or a small quantity ofmedicaments 11 as illustrated in FIGS. 21A-22. In the example, cells 41include 64 total cells grouped in four rows of 16 cells.

Cells 41 are indexed for movement along a track (not shown) in exceptionstorage apparatus 43. Cells 41 are indexed forward along the tracktoward an opening (not shown) in the bottom of apparatus 43 so that thecontents of each cell 41 fall through a cell bottom opening (not shown)and to a packaging device within dispensing machine 45 through chutes,hoppers or other guide structure, or by a mechanical device such as anauger. Medicaments 11 may be discharged from cells 41 by any othersuitable means including a movable gate (not shown) over a cell bottomoutlet (not shown), or by a solenoid, air-powered actuator, air-jet, ormechanical arm which ejects the medicament through an upper cell inlet209 of the type shown in FIG. 19A. The medicaments 11 fall via chutes,guides to a packaging device or are directed to packaging device bymechanical means (e.g. an auger).

In the example, automated dispensing machine 45 includes apouch-package-type packaging apparatus (not shown) within a lowerportion of cabinet 191. Alternatively, packaging apparatus capable ofpackaging medicaments 11 into other container types (e.g., bottles,vial, blister packages) may be utilized. A pouch-package-type packagingdevice includes a form-fill-seal packaging device. A “form-fill-seal”packaging device forms a package (i.e., a pouch) in a web of packagingmaterial, fills the package with the medicament(s), and seals thepackage forming a plurality of discrete packages, or pouches.

In the example, one or more medicament 11 discharged from thecassette-type storage apparatus (not shown) or exception storageapparatus 43 is loaded into separate pouches 202 formed (e.g., byheat-sealing or sonic welding) in a web of packaging material 204 asillustrated in FIG. 22. Information can be printed on each pouch 202 bya printer (not shown) associated with dispenser 45 and such informationcan include the patient's name 206, medicament name and quantity 208,prescription number 210, date 212, instructions for taking themedicament 214 (such as time of day the medicament is to be taken) andmachine-readable indicia 216 (such as a bar code) representative of theaforesaid information. Pouch packages are ideal for use in administeringmedication regimens because the exact medicaments to be taken at a giventime can be packaged together in a single pouch, and the pouches can beorganized and labeled in the exact order in which each medicament is tobe taken, for example, morning, noon and evening. An exemplary automateddispensing machine 45 is a model ATP 320, 371, or 384 dispensing machineavailable from The Chudy Group, LLC of Powers Lake, Wis.

Transfer of medicaments 11 from holder cells 33 to exception storageapparatus 43 will now be described in connection with FIGS. 21A-21C. Inthe example, cells 33 of holder 13 are positioned and arranged so thatthey have a pattern which is identical to that of cells 41 in exceptionstorage apparatus 43. Holder 13, therefore, can be placed directly ontop of exception storage apparatus 43 as shown in FIG. 20 and FIGS.21A-21C with each cell 33 and 41 completely aligned and in registry. Inthe example, holder 13 and exception storage apparatus 43 each have 64total cells 33, 41 grouped in four rows of 16 cells. Human-readableindicia 211 is preferably provided on exception storage apparatus 43(FIG. 19A) so that each cell 33 on holder 13 has the same indicia 47 asindicia 211 on exception storage apparatus 43. The cell 33 pattern andindicia 47 of holder 13 is most preferably identical to the cell 41pattern and indicia 211 of exception storage apparatus 43.

Referring again to FIGS. 20 and 21A-21C, the verified holder 13 is takento exception storage apparatus 43 of dispensing machine 45 by atechnician or pharmacist. Holder 13 is set on top of exception storageapparatus 43. Legs 51, 53 position holder 13 over exception storageapparatus 13 as shown, for example, in FIGS. 21A-21C to ensure thatholder 13 is in the correct orientation on exception storage apparatus43 with correct alignment of cells 33, 41. Once aligned, holder 13 isinitially in the position shown in FIG. 21A.

At this point in the process, identification element 81 is detected bydetector 84 of dispensing machine 45. If the correct holder 13 ispositioned over exception storage apparatus 43, thetechnician/pharmacist is given a prompt signal by video display 201. Ifan incorrect holder 13 is positioned over exception storage apparatus43, then display 201 prompts the technician/pharmacist to not transferthe medicaments 11 and may present an error message and/or alarm. Inaddition, system 10 or 10′ may deactivate dispenser 45 preventingdispenser 45 operation until the correct holder 13 is in place or thetechnician/pharmacist overrides the system 10, 10′.

Prior to medicament 11 transfer and as shown in FIG. 21A, shuttle member55 is in its “closed” position with cell 33 outlets 39 covered byshuttle member 55. Medicaments 11 cannot exit cells 33 in this closedposition.

Next, and as shown in FIG. 21B, the technician grasps pull 61 and movesshuttle member 55 in the direction of arrow 217. Movement of shuttlemember 55 in the direction of arrow 217 partially opens cell outlets 39as openings 59 in shuttle member 55 are aligned with cell outlets 39. Asa result, medicaments 11 begin to fall by means of gravity into thealigned cells 41 of exception storage apparatus 43.

Finally, and as shown in FIG. 21C, the technician moves shuttle member55 fully in the direction of arrow 217 by means of pull 61 to fullyalign openings 59 in shuttle member 55 with cell outlets 39. Cells 33are fully open in this position causing medicaments 11 in cells 33 tofall into the corresponding cells 41 of exception storage apparatus 43.Exception storage apparatus is now correctly loaded and is ready fordispensing and packaging of the slow mover medicaments 11 stored incells 41. This loading process shown in FIGS. 21A-21C is very rapid(less than one minute) and enables automated dispensing machine 45 to bequickly returned to service.

Systems 10, 10′ accurately and rapidly enable loading of medicaments 11in the exact order in which the medicaments 11 are to be loaded intoexception storage apparatus 43. The medicaments 11 are rapidly verifiedby the system 10, 10′ and docking station 15 in a way which is notpossible based solely in reliance on written instructions. This isbecause selective operation of the indicators 49 permits pharmacypersonnel to load and verify the contents of holder 13 without having totake his or her eyes off of the holder 13 to read instructions. Eachexemplary system 10, 10′ therefore, speeds the holder-loading processwhile at the same time providing a high confidence level that each cell33 and 41 has been loaded with the correct medicament 11. Accurateloading of medicaments 11, in turn, provides a better level of care forall patients which, of course, is always the primary objective of anypharmacy, hospital, long-term care facility or other care-giver.

And, time required for selecting, verifying, and loading medicaments 11into the automated dispensing machine is significantly decreased. Thisfrees pharmacists to better serve their patients and enables theautomated dispensing machine 45 to be immediately returned to service.The result once again is improved patient care and reduced cost ofoperation to the pharmacy, hospital, long-term care provider or otheroperator.

While the principles of this invention have been described in connectionwith specific embodiments, it should be understood clearly that thesedescriptions are made only by way of example and are not intended tolimit the scope of the invention.

What is claimed is:
 1. A method for management of medicament-type itemsenabling pharmacy personnel to rapidly and accurately perform repetitivemanual tasks of hand-loading a holder having medicament-holding cellswith at least one type of medicament, the method comprising the stepsof: docking a portable holder having medicament-holding cells with apharmacy docking station, the docking station including structure towhich the holder is temporarily docked during hand-loading ofmedicaments into the cells, the pharmacy docking station furtherincluding circuitry which enables operation of indicators between atleast yes and no states to provide visible information viewable on thedocked holder indicating the cell into which each medicament is to behand-loaded; indicating the cell of the docked holder into which eachmedicament is to be hand-loaded by operating the docking stationcircuitry so that an indicator is in the yes state to provide thevisible information viewable on the docked holder proximate the cellinto which the medicament is to be hand-loaded; and hand-loading themedicament into the indicated cell.
 2. The method of claim 1 wherein theindicating step further includes activating the indicator.
 3. The methodof claim 2 wherein the indicator is a lamp.
 4. The method of claim 1further comprising, before the indicating step, the steps of: displayinga type of medicament to be hand-loaded into the docked holder; andselecting the displayed type of medicament, whereby the selectingtriggers the indicating step.
 5. The method of claim 1 furthercomprising the steps of: carrying the holder to an automated dispensingmachine; and transferring the medicaments from the holder to theautomated dispensing machine.
 6. A method of hand-loading a containerwith at least one type of medicament, the method comprising the stepsof: getting a portable container, the container having plural cells forholding medicaments; docking the container at a docking station havingstructure to which the container is temporarily docked duringhand-loading of medicaments into the cells, the docking station furtherhaving circuitry which enables control of visible information viewableon the docked container between at least yes and no states to indicatethe cell into which each medicament is to be hand-loaded; controllingthe visible information through the docking station circuitry such thatthe yes state information is visible on the docked container proximatethe cell into which each medicament is to be hand-loaded; hand-loading amedicament into the cell proximate the yes state information; andremoving the docked container from the docking station after the cellshave been loaded with the medicaments.
 7. The method of claim 6 whereinthe getting step further includes getting one container of a pluralityof containers.
 8. The method of claim 6 wherein the controlling stepfurther includes activating an indicator to provide the yes stateinformation.
 9. The method of claim 8 wherein the indicator is a lamp.10. The method of claim 8 wherein the controlling step further includesproviding the yes state information through the docked container whenthe indicator is activated.
 11. The method of claim 6 furthercomprising, before the controlling step, the steps of: displaying a typeof medicament to be hand-loaded into the docked container; and selectingthe displayed type of medicament, whereby the selecting triggers thecontrolling step.
 12. The method of claim 11 further comprising, if anymedicaments remain to be hand-loaded into the docked container,repeating the displaying, selecting, controlling and hand-loading stepsuntil all of the medicaments have been hand-loaded into the dockedcontainer.
 13. The method of claim 12 further comprising, after all ofthe medicaments have been hand-loaded into the docked container, thesteps of: docking the container with the docking station if thecontainer is not already docked; displaying each type of medicament thatwas hand-loaded into the docked container; for each type of displayedmedicament, controlling the visible information through the dockingstation circuitry such that the yes state information is visible on thedocked container proximate the cell into which each medicament washand-loaded; and verifying that the medicament in each cell proximatethe yes state information is of the correct type.
 14. A method forenabling a human to rapidly and accurately perform repetitive manualtasks of hand-loading a container having cells with at least one type ofitem in an arrangement for packaging of the items, the method comprisingthe steps of: docking a portable container having cells for holdingitems with a docking station, the docking station including structure towhich the container is temporarily docked during hand-loading of itemsinto the cells, the docking station and a controller controlling visibleinformation between at least yes and no states such that the visibleinformation is viewable on the docked holder to indicate to the humanthe cell into which each item is to be hand-loaded; operating thecontroller and the docking station to control the visible informationsuch that yes state information is visible to the human on the dockedcontainer proximate the cell into which each item is to be hand loadedin the arrangement for packaging; and hand-loading each item into thecell proximate the yes state information.
 15. The method of claim 14wherein the items are medicaments.
 16. The method of claim 14 whereinthe operating step further includes activating an indicator to providethe yes state information.
 17. The method of claim 14 further comprisingthe step of removing the docked container from the docking station afterthe cells have been hand-loaded.
 18. The method of claim 17 furthercomprising, after the removing step, the steps of: docking a furtherportable container having item-holding cells with the docking station;and performing the operating and hand-loading steps for the cells of thedocked further container.
 19. The method of claim 14 further comprising,before the operating step, the steps of: displaying a type of item to behand-loaded into the container; and selecting the displayed type ofitem, whereby the selecting triggers the operating step.
 20. The methodof claim 19 further comprising, if any item remains to be hand-loadedinto the container, repeating the displaying, selecting, operating, andhand-loading steps until all of the items have been hand-loaded into thecontainer.
 21. The method of claim 20 further comprising, after all ofthe items have been hand-loaded into the container, the steps of:docking the container with the docking station if the container is notalready docked; displaying each type of item that was hand-loaded intothe container; operating the controller and the docking station tocontrol the visible information such that yes state information isprovided for each displayed type of item; and verifying that the item ineach cell proximate the yes state information is of the correct type.22. The method of claim 21 further comprising, after the verifying stepfor each type of item, the steps of: carrying the container to anautomated dispensing machine; and transferring the items from thecontainer to the automated dispensing machine for the packaging.